Abstract
A case of ischemic colitis is presented here. A patient, 70-year-old male, was admitted to our hospital with a chief complaint of melena. The first barium enema study (March 1, 1977), performed at the 6th day after the onset of melena, revealed disappearance of haustration and a tubular narrowing from the mid-sigmoid to the lower part of the descending colon. A “thumb-printing” change was noted on the lower part of the descending colon On occasion of the second examination (April 13, 1977), some linear shadows, passing longitudinally through the intestine, and some mucosal folds crossing the linear shadows were visualized. Sacculations were also shown on the lower part of the descending colon. The linear shadows and Sacculations still remained at the third examination (July 26, 1977). A colonofiberscopy was done on the 23rd day after the onset of the disease. A hyperemic change was found which ran longitudinally from the sigmoid to the descending colon, and there were converging mucosal folds toward this hyperemic part. No abnormality was noted on the mucosa at the oral or anal side of the lesion. At the time of the second colonoscopy (April 22' 1977), the hyperemia already disappeared and only remarkable converging folds and sacculations remained. The histological study at the first colonoscopy revealed erosions, an increase of small blood vessels and fibroblasts, and an infiltration of inflammatory cells which mainly consisted of mononuclear cells. Abdominal angiography (April 7, 1977) showed changes in diameter and meandering of the vessels from the iliac artery to the abdominal aorta. Abnomality was not noted on the inferior mesenteric artery. Melena subsided by the symptomatic therapy and there has been no sign of recurrence for almost 2 years since then.
